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Texas Family Planning Funding Remains Inadequate as Clinics Struggle Under Restrictions

August 9, 2013 — Although Texas lawmakers have restored family planning funding in the 2014-2015 state budget, clinics continue to struggle from drastic cuts in 2011 and a state law that bars "abortion affiliated providers" from receiving the money, the Texas Tribune/New York Times reports.

Meanwhile, women's health advocates fear a recently enacted law (HB 2) that threatens to close many abortion clinics will compound Texas women's difficulties in accessing reproductive health care (Aaronson, Texas Tribune/New York Times, 8/8).

Legislative Action

The Texas Legislature in 2011 cut the state's family planning budget by two-thirds and blocked funding to Planned Parenthood and other women's health clinics affiliated with abortion providers (Women's Health Policy Report, 7/22).

As a result of the cuts, 76 of Texas' family planning clinics have closed or stopped providing family planning services, according to the most recent survey by University of Texas-Austin researchers who are monitoring the impact of the cuts. Although the state has added at least 16 new family planning providers to its program, the researchers estimated that the state's investment in family planning averted 30,000 fewer unintended pregnancies in 2012 than in 2010.

To mitigate the effect of the 2011 cuts, Texas legislators during the 2013 session increased women's health funds to $214 million for the 2014-2015 state budget, up from $109 million in the previous budget. Of those funds, $100 million is dedicated to expanding primary care for an additional 170,000 women; $71 million will go toward operating the Texas Women's Health Program; and $43 million will be used to replace the family planning grants that the federal government awarded to another organization to distribute.

The state will dedicate 60% of the primary care expansion funds to family planning services; expand the number of contracted providers from 57 to 100; and provide wraparound benefits -- including prenatal and dental care for pregnant women -- which are not covered in other programs.

Funding Remains Inadequate

Despite the increase in funding, the 2014-2015 budget will only meet one-third of the need for subsidized family planning services in the state, according to the Texas Women's Healthcare Coalition, which represents 39 medical and advocacy organizations in Texas.

The coalition also said the Department of State Health Services has not adequately prioritized such services. Janet Realini, the coalition's chair, said, "The bottom line for us is we want the women to be able to get the services." She added, "There's an advantage of guiding that money to the family planning, that preventive care piece, because that's where the cost savings occur."

However, David Lakey -- the state's health services commissioner -- said in a letter responding to the coalition that the department had adequately prioritized family planning services. He pointed out that the agency held nine informal meetings for feedback on the primary care expansion, adding that the agency intends to meet the 60% target for family planning services "and carry out the program as directed by the Legislature."

Enforcement of Antiabortion Law Looms

In late October, the state will begin enforcing provisions in a recently enacted antiabortion-rights law that bans most abortions after 20 weeks of pregnancy and requires that physicians who perform abortions have admitting privileges at a hospital within 30 miles. In September 2014, a provision takes effect that requires abortions to be performed at ambulatory surgical centers.

According to the Tribune/Times, at least 36 of the 42 abortion clinics in the state do not meet the ambulatory surgical center standards. It is unknown whether any of the six clinics that do qualify will be able to obtain physician admitting privileges.

The abortion clinic restrictions will compound the burden on women already struggling to access contraception amid the patchwork of remaining clinics, women's health advocates said.

Katy Caldwell, CEO of Legacy Community Health Services, said that if lawmakers "really don't want people to have abortions, then they should have ready access to family planning." She added that women in rural areas in particular have very limited contraceptive access "because so many clinics have had to shut down access to family planning" (Texas Tribune/New York Times, 8/8).